BMJ  2007;335:502-507 (8 September), doi:10.1136/bmj.39304.678194.AE

Clinical Review

Perennial rhinitis

¹ Charing Cross and Royal Brompton Hospitals, London; and Imperial College of Medicine, London, ² Imperial College of Medicine, National Heart and Lung Institute, London; and Royal Brompton Hospital, London

The first 150 words of the full text of this article appear below.

Perennial rhinitis can be defined clinically as an inflammatory condition of the nose characterised by nasal obstruction, sneezing, itching, or rhinorrhoea, occurring for an hour or more on most days throughout the year. Rhinitis is commonly managed by both primary and secondary care physicians. Although most cases can be diagnosed and treated in primary care, referral to secondary care is often necessary when patients do not respond to treatment or other diagnoses are suspected. A recent large scale, cross sectional study in six western European countries found that the overall prevalence of rhinitis was 23%.¹ The study also showed that the condition is often undiagnosed, as 45% of patients with investigator confirmed allergic rhinitis had not previously received a diagnosis from their physicians. A published review of previous population based studies showed that, as with asthma, both seasonal and perennial rhinitis seem to be increasing.²

Summary points Perennial allergic rhinitis is a . . . [Full text of this article]

How is perennial rhinitis classified?

Allergic rhinitis
Non-allergic rhinitis

What is the differential diagnosis?

How is the diagnosis made?

Box 1 Taking a history

What investigations are needed?

Skin prick test
Other tests
Blood tests
Erythrocyte sedimentation rate
Imaging
Further tests
Swabs, smears, and biopsies

How is perennial rhinitis treated?

Allergen avoidance
Box 2 House dust mite avoidance measures
Medical treatment
Surgery
Box 3 Surgical treatment (evidence levels 3 and 4)
Immunotherapy
Sources and selection criteria
Additional educational resources
Resources for health professionals
Resources for patients
Tips for non-specialists
What to exclude (differential diagnosis)
When to refer to a specialist

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